| NPI | 1952645392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 201807062NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201242524RN) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2020-02-18 |